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EXCLUDED AND INVISIBLE CHILDREN IN AFRICA

PAULUS M. ZULU

1. INTRODUCTION

In the report entitled ‘Excluded and Invisible’ the United NationsChildren’s Fund (UNICEF) lists four factors as the root causes of exclusionof children from mainstream society. These are poverty, weak governance,armed conflict and HIV and AIDS (UNICEF: 2006). All four exist in Africaeither individually or in combinations. The report further states that ‘at theextremes children can become invisible, in effect disappearing from viewwithin their families, communities and societies, and to governments,donors, civil society, the media and even “other children”’ (Ibid). Excludedchildren may not be only invisible, they are unprotected as well, and exclu-sion is not simply a matter of the present, it impacts severely on the lifechances and, consequently, the future of children. This paper seeks toexplore the position of children in Africa, and to establish the extent towhich these four factors have ‘conspired’ to exclude children from partici-pation in life processes that have a definite contribution to their presentand future wellbeing as citizens, first of their own nations and secondly ofthe world. The paper draws on the data provided by the 2006 Report of theUnited Nations Children’s Fund.

2. THEORETICAL FRAMEWORK

The theoretical position taken in this paper is that generally there is adirect relationship between poverty at the national level and the capacity ofnational governments to deliver basic goods and services to their popula-tions. First, because of poverty national governments have a weak tax baseand consequently a weak productive capacity. Secondly, within the popula-tion there is a disproportionate balance between the demand for goods and

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Vanishing Youth? Solidarity with Children and Young People in an Age of Turbulence Pontifical Academy of Social Sciences, Acta 12, Vatican City 2006 www.pass.va/content/dam/scienzesociali/pdf/acta12/acta12-zulu.pdf

services and the capacity to pay for the same. Thirdly, the weak tax and pro-duction bases severely limit the ability of national governments to subsidisethe services in demand. Both government and the population are thuscaught in a vicious circle and the result is weak governance. This positionis inevitably aggravated by factors ostensibly from outside the system, suchas armed conflict and HIV and AIDS. I use the qualification ‘ostensibly’ ina guarded context because while a direct relationship between poverty andarmed conflict cannot be imputed, weak governments tend to be prone toarmed conflict. Also, poverty reflects the inability of the state to protect itscitizens, and does not only provide a fertile ground for the spread of HIVand AIDS, it also creates conditions which make it very difficult to managethe disease. Among the poor, HIV and AIDS are extremely difficult to con-tain and have reached pandemic proportions.

What complicates the position of children under these circumstances isthat, as the UNICEF Report states, ‘children are disproportionately repre-sented among the poor’ (UNICEF Report: 2006). Reasons are that the leastdeveloped countries are generally the poorest, and the poorest countriestend to have the youngest population profiles, and income-poor familiestend to have more children than the richer ones (Ibid.). Africa is one of thepoorest and least developed regions in the world and, therefore, fits wellinto the prototype in terms of poverty and the exclusion of children.Political conditions in Africa exacerbate the position of children as bothconflict and HIV and AIDS are rife. Sub-Sahara Africa is the world’s mostafflicted region by HIV and AIDS, and conflict is a common feature in theregion. Between 1952 and 1996 Africa had experienced 82 coups and 48 ofthese had occurred between 1976 and 1996. Countries such as Angola,Mozambique, Sudan, Ethiopia, Burundi, Rwanda, the DemocraticRepublic of Congo, Liberia, Cote d’Ivoire, have either had extensive warswhich only ended not more than a decade ago and, therefore, still in theprocess of reconstruction, or the conflict is not yet completely resolved.Governments in these states have not yet strengthened to a position wherethey can render services without external assistance. In these countries, theenvironment renders children vulnerable to exclusion and invisibility.

3. FORMS OF EXCLUSION AND INVISIBILITY

In broad terms children are excluded or rendered invisible when theycannot access the basic goods and services necessary for children to lead a

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EXCLUDED AND INVISIBLE CHILDREN IN AFRICA 191

normal life, and when circumstances are such that their future life chancesand prospects are limited or obliterated by acts of deprivation. The absenceof or inability to use antenatal care services by pregnant mothers, the spi-ral of poverty leading to nutritional deprivation and consequently to chil-dren born with a low birth weight or dying as infants; and the presence ofsocio-economic conditions which cause children to miss on schooling or toabandon school early, individually or severally cause children to be exclud-ed. What is worse and of great concern is that marginalised and excludedchildren are not only deprived in the present, they are also rendered vul-nerable and exploitable in the future.

Forms of exclusion can result from various levels from the inability of thechild’s home to provide for the necessary requirements for a healthy life andappropriate growth path, to the inability of the state or government to pro-vide the necessary goods and services such as registration at birth, educationand health. In extreme forms, basic requirements such as shelter, clean drink-ing water, adequate sanitation and food comprise indicators of exclusion.

4. METHODOLOGY

Data comprising the body of this paper has been extracted from theUnited Nations Children’s Fund Report of 2006. The discussion and analy-sis use selected indicators of exclusion and these are:

(i) Life ChancesLife chance indicators include attendance of ante-natal care by pregnantmothers, infant mortality, under five mortality and life expectancy atbirth. However, the prevalence of HIV and AIDS could be a distorting fac-tor with regard to life expectancy at birth. As research improves andaccess to antiretroviral therapy increases the number of deaths, especial-ly among the younger generations may reduce drastically.

(ii) NutritionThis encompasses the percentage of children born with a low birthweight, underweight, wasting and stunting.

(iii) Economic FactorsThree selected indicators fall into this section: percentage of the popu-lation earning below one US dollar per day, the gross national incomeper capita and the net official development assistance as a percentageof the recipient’s gross national income.


(iv) EducationThree selected indicators comprise this section. They are primaryschool enrolment, the number of primary school entrants reachinggrade five, and the secondary school attendance ratio.

(v) HealthUnder this rubric falls improved drinking water, adequate sanitationfacilities, immunisation against Pulmonary Tuberculosis, Diphtheria,Polio, Measles and Hepatitis B and the number of children under four-teen years of age infected by HIV and AIDS.

(vi) Child ProtectionThis covers birth registration, child labour, child marriage, female gen-ital mutilation, and children orphaned by AIDS.

Twenty countries were selected at random from a list of all African coun-tries, and the distribution across the continent is as follows:

(i) North Africa: Egypt and Ethiopia;

(ii) West Africa: Benin, Cote d’Ivoire, Equatorial Guinea, Gambia, Ghanaand Liberia;

(iii) Central Africa: Burundi, Central African Republic, Congo DemocraticRepublic and Rwanda;

(iv) East Africa: Malawi, Mauritius, Seychelles, Tanzania and Uganda;

(v) Southern Africa: Namibia, South Africa and Zimbabwe.

The selected countries fall within a wide spectrum in terms of econom-ic capabilities (gross domestic product and levels of economic develop-ment), political stability (strong and weak government and extent of demo-cratic practices) and the human development index. They range from thepoorest and almost complete dependence on foreign aid for food and devel-opment infrastructure as is the case with Ethiopia, Burundi and Rwanda tothe well developed and almost self sufficient such as Egypt, South Africa,Mauritius and the Seychelles.

Four of the twenty countries selected (Cote d’Ivoire, the DemocraticRepublic of Congo, Ethiopia and Liberia) have experienced serious internalcivil wars or armed conflict in the new millennium, four (Burundi, Rwanda,Uganda and Zimbabwe) are politically unstable at present either recoveringfrom serious internal strife or deteriorating and the rest have had no prob-lems over the past ten years. The selected countries have, therefore, the req-uisite attributes to constitute explanatory variables in the analysis.

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Finally, Sub-Sahara Africa is considered as the world’s epicentre of HIVand AIDS. The UNICEF Report states that more than 80 percent or 12.1million of the world’s AIDS orphans come from Sub-Saharan Africa ‘reflect-ing not only the region’s disproportionate burden of HIV infection, but alsothe epidemic’s relative maturity’ (UNICEF Report: 2006, p. 16). As is thecase with armed conflict, HIV and AIDS attack the family which is the firstline of defence in the protection of children. Also, the epidemic disruptseducation and school life by killing teachers. Children thus suffer at threelevels, first at the level of direct protection from parents, secondly theythemselves might be infected thus reducing their chances to live, and third-ly they have reduced life opportunities further exacerbating their exclusion.It is in Africa where almost entire villages have been wiped out by the AIDSepidemic as has been the case in Uganda, and where civil wars have dis-placed millions and brought in armies of occupation (cf. Rwanda, Ethiopiaand the Democratic Republic in Congo), and promoted the recruitment ofchildren into armies as was the case in Sudan, Liberia and the DemocraticRepublic of Congo. It is this tapestry of factors in Africa that provides anappropriate terrain for exploring the four main factors that contribute tothe exclusion and invisibility of children.

5. INDICATORS OF EXCLUSION

The following section examines data on the six selected indicators ofexclusion, in twenty African countries chosen at random, using the fourmain factors of exclusion i.e. poverty, weak governance, armed conflict andHIV and AIDS. There is empirical data on three of the factors, i.e. poverty,armed conflict and HIV and AIDS. Demonstrable indicators of these suchas, for instance, per capita income and the gross domestic product forpoverty; wars and uprisings for armed conflict; and statistics on incidenceand prevalence for HIV and AIDS exist. However, the factor of weak gover-nance is elusive and can only be inferred from instability which in itself isdeduced from the history of a particular country.

5.1. Life Chances

Life chance indicators determine if an individual has chances to liveincluding how long he or she may expect to live. They include ante-natalcare coverage of expectant mothers, infant mortality calculated in livebirths per 1 000 births, under five mortality and life expectancy.


5.1.1. Ante-Natal Care Average

With the exception of Rwanda which had experienced armed conflict inthe 1990s all countries with a high index of ante-natal care coverage havestable governments irrespective of the levels of democratisation. On thecontrary the four countries with the lowest percentage of ante-natal carecoverage, i.e. Democratic Republic of Congo, Ethiopia and the CentralAfrican Republic have either internal conflict (Congo DRC and Ethiopia) orhave experienced turbulence as a result of armed conflict in neighbouringstates (the Central African Republic). The exception in this case is Egyptwhere the low level of ante-natal care could be attributed to factors otherthan armed conflict or weak governance.

5.1.2. Infant Mortality

Data on infant mortality has two reference points, 1990 and 2004. Thereare two notable observations to make. The first is the ratio of children whodie as infants expressed per 1 000 live births, and the second is an exami-nation of this ratio at the two reference points mentioned.

Nine of the twenty countries have infant mortality ratios of over 110 per1 000. Only one of these, Malawi, has not experienced armed conflict or aspill over from armed conflict in the past ten years. The lowest ratios are inthe countries with advanced economies and stable government (Seychelles,Mauritius, Egypt, Namibia and South Africa). Also, despite under-develop-ment, countries with stable government have performed relatively better onthis indicator (Ghana, Tanzania, Zimbabwe, Uganda, Gambia and Benin).

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TABLE 1. LIFE CHANCES INDICATORS.



Armed conflict appears to constitute a constant variable where the rateof infant mortality has risen between 1990 and 2004. For instance, in Coted’Ivoire this figure rose from 103 to 117 per thousand, in Rwanda from 103to 118. The same position prevailed in the Central African Republic wherethe spill over from conflict in the Great Lakes region was felt intensely andin Equatorial Guinea where the spill over from the conflict in the neigh-bouring Cote d’Ivoire could have had an effect. Both South Africa andZimbabwe record slight increases from 1990 most probably because of HIVand AIDS reaching maturity.

5.1.3. Under Five Mortality

As is the case with infant mortality, data on under five mortality refersto two time periods, 1990 and 2004. The lowest figures recorded are incountries with relatively advanced economies and stable governments(Seychelles, Mauritius, Egypt, Namibia and South Africa). However, SouthAfrica shows a slight increase from 1990 (60 to 67), an observation whichcould be attributed to the prevalence and maturity of AIDS in the country.Significantly, despite the figures being high (160:138) in Uganda, there is aremarkable decline between 1990 and 2004. Uganda is often cited as oneAfrican country that has been able to reverse both the incidence and preva-lence of HIV and AIDS within its borders.

Relatively poorer countries demonstrate high figures for both periods,but there is a relative decline in this indicator in poor but stable countriessuch as Benin, Gambia, Ghana, Malawi and Tanzania. On the contrary,countries that have experienced armed conflict also show an increaserather than a decline in under five mortality. This is true of Cote d’Ivoire,Rwanda, the Central African Republic and Equatorial Guinea, the lattertwo more from the spill over from the neighbouring war-torn countriesthan from internal developments. The exception in this case is Ethiopiawhere a decline from 204 to 166 is recorded.

5.1.4. Life Expectancy at Birth

This is an indicator which has been distorted significantly by the preva-lence and maturity of the HIV and AIDS epidemic. Also, all the factors caus-ing the exclusion of children converge on this indicator. There are only twocountries (Egypt and Mauritius) which show a respectable life expectancyof more than 70 years. Both are relatively well-developed economically and


fall under the rubric of medium income countries, and both have a low ifnot very low incidence and prevalence of HIV and AIDS. Gambia andGhana have a very low HIV adult prevalence, (at 1.2 and 3.1 percent respec-tively), both have stable governments and have experienced no armed con-flict in the past ten years or more. However, both countries are poor andhave economic dependency ratios above 10 percent of their gross nationalincome. The two have better life expectancies (at 56 and 57 years respec-tively) than the rest of the countries in the sample. While South Africa andNamibia have fared well in all the other indicators in this sub-cluster andhave compared favourably with Egypt, both have been disadvantaged con-siderably by HIV and AIDS. The high HIV adult prevalence ratio in bothcountries (at 21.5 and 21.3 percent respectively), resulting in a very highpopulation living with HIV in the 15-49 age group in South Africa (4 500-6 200), has decreased life expectancy considerably.

5.2. Nutrition

The first goal in the millennium agenda is to eradicate extreme hungerand poverty. Four selected sub-indicators falling under the rubric of nutri-tion are: the percentage of infants born with a low birth weight, under-weight, wasting and stunting.

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TABLE 2. NUTRITIONAL INDICATORS.

5.2.1. Infants born with a Low Birth Weight

There were minor differences across the twenty countries in the samplewith regard to this indicator. On average, just over a tenth (approximately14%) of children were recorded as born with a low birth eight in 2004. Only



Rwanda, Zimbabwe, Egypt and the Democratic Republic of Congo record-ed numbers below the average of fourteen for the rest of the sample.

5.2.2. Moderate and Severe Underweight

The effects of armed conflict were demonstrably evident with regard tochildren recorded as suffering from moderate to severe underweight. Forinstance, in Rwanda and Ethiopia, both recovering from large scale armedconflict, the percentage of underweight children was 45 and 47 respective-ly. This was about twenty percentage points above the average for the con-tinent. Other war-ravaged countries: the Democratic Republic of Congo,Liberia and Rwanda recorded figures above the twenty-five percent mark.In contrast, countries regarded as economically advanced, the Seychelles,Egypt, South Africa and Zimbabwe recorded low figures (under 15%).

5.2.3. Moderate and Severe Wasting

The highest figures of wasting recorded (around the 10% mark) were inthe Democratic Republic of Congo and in Ethiopia. Both countries haveexperienced protracted large scale armed conflict and both are largelydependent on foreign aid for development assistance. The lowest figuresrecorded were in South Africa, Egypt, Tanzania and Uganda, all of whichhave enjoyed stable governance in the last fifteen years.

5.2.4. Moderate and Severe Stunting

Predictably, strife-torn countries fared badly on this indicator. Stuntingis a long-term condition in comparison with underweight and wasting.Therefore, countries that have suffered long drawn armed conflict woulddemonstrate higher ratios of stunted children than countries that haveenjoyed relative peace. The highest figures recorded were in Burundi (57%)and Ethiopia (52%). With the exception of Tanzania, Malawi and Ugandawhere there has been no armed conflict in the past 15 years, all the othercountries that recorded high figures (above 35%) had experienced eitherarmed conflict or spill-overs from armed conflict in the past 15 years. Coted’Ivoire is the only country that has been through large scale armed conflictrecently but has recorded low figures of stunting (17%).

Egypt, Gambia, Namibia and South Africa, all of which have enjoyedstable governments and have not been through armed conflict in the pastfifteen years have low figures of stunting.


5.3. Education

Three selected indicators used to assess the extent to which childrenwere excluded from education were:

(i) the net primary school enrolment ratio, i.e. the number of childrenenrolled at primary school as a percentage of children of primaryschool-going age;

(ii) the number of primary school entrants who reach grade five as a per-centage of their initial enrolment; and

(iii) the secondary school attendance ratio i.e. the number of childrenenrolled in secondary school as a percentage of children in the second-ary school-age group.

Data exists for both male and female children with regard to the first andthird indicators, i.e. primary and secondary school attendance.

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TABLE 3. EDUCATIONAL INDICATORS.

5.3.1. Net Primary School Enrolment Ratio

Countries with the highest net primary school enrolment were: theSeychelles, Mauritius, Egypt, Equatorial Guinea, South Africa, Rwandaand Tanzania (all above the 80% mark). The lowest primary school enrol-ment, all except Rwanda have been conflict free in the past ten years.



5.3.2. Percentage of Primary School Children Reaching Grade 5

Countries with the highest ratio of net primary school enrolment alsohave the highest number of primary school entrants reaching Grade Five.However, in Equatorial Guinea and in Rwanda, there is a very considerabledrop in pupils reaching Grade Five whilst in South Africa there is a signif-icant drop. Conditions in Rwanda have not been favourable, with protract-ed armed conflict, poverty and an HIV and AIDS infection rate of over fivepercent. In South Africa, of the three causal factors of exclusion, the highprevalence of HIV and AIDS is the only one that can be isolated. The extentto which this factor has affected schooling at primary level is uncertaingiven that the number completing primary school remains constant at thesecondary school level.

5.3.3. Secondary School Attendance Ratio

There is a considerable drop from primary to secondary school enrol-ment in all the countries in the sample with the exception of the Seychelles,Egypt, Mauritius and South Africa. All the countries which did not suffer asignificant drop have sound economies, have enjoyed relative peace in thepast ten years, have stable governments and, with the exception of SouthAfrica, have a low HIV and AIDS adult prevalence.

5.4. Child Protection

Selected indicators of child protection were:

(i) Birth RegistrationUnregistered children are excluded from the state’s responsibility asthey are not part of the citizenry;

(ii) Child LabourChildren who do not enjoy protection either from the family or from thestate are vulnerable to exploitation as a source of cheap labour byunethical entrepreneurs;

(iii) Child MarriageUnscrupulous persons may prey on unprotected children. Activitiesrange from child marriage to child prostitution. Also, poor parents maygive their children away to marriage in exchange for dowry;


(iv) Children Orphaned by AIDSWith the AIDS epidemic maturing, parents die and leave their childrenunprotected. This is particularly so as the most vulnerable age cohortfalls within the reproductive age; and

(v) Female Genital MutilationThis is probably one indicator which is influenced by cultural beliefsrather than by the four main factors that determine the exclusion ofchildren.

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5.4.1. Birth Registration

Thirteen of the twenty countries in the sample registered their childrenat birth or have registration figures available. Registration varies from alow four percent to three quarters (75%) of the children. Child registrationis probably an indicator which is directly linked to the capability and effi-ciency of the state. It takes political will to include child registration in thecountry’s legal system as part of the legislation on children.

5.4.2. Child Labour

There were no figures on child labour in six countries, and four of thesix (Seychelles, Mauritius, South Africa and Namibia) are relatively devel-oped and economically capable. Liberia has not fully recovered from theravages of civil war, while for the past five years Zimbabwe has been expe-riencing increasing political turmoil short of civil war. In the rest of the

TABLE 4. CHILD PROTECTION INDICATORS.



countries in the sample, figures on child labour range from about a quar-ter of the population to a high of above half the population of children.There are no gender differentials as both male and female children areequally vulnerable.

5.4.3. Child Marriage

Five countries in the sample did not have figures on child marriage. Therandomness of the practice seems to suggest cultural rather than econom-ic and political factors as the motive. For instance, the lowest figures in thespectrum are in South Africa and Namibia, both Southern African coun-tries, whilst Uganda, Tanzania, Malawi and Ethiopia (all East African coun-tries) have high figures. The Central African Republic, with very high fig-ures, is not far from East Africa, whilst the West African countries (Ghana,Cote d’Ivoire and Benin) fall in the middle belt of the spectrum.

5.4.5. Female Genital Mutilation

Six countries had recorded figures, and the data presents this indicatoras determined by the cultural belief system rather than by economic andpolitical factors.

5.5. Economic Development

Two economic development indicators selected were: the percentage ofthe population earning below one US dollar per day; and the gross nation-al income per capita. In the first place, it was necessary to establish if therewas any correlation (which should be presumed) between the extent ofpoverty as determined by the ratio of persons earning below one US dollarper day and the gross national income per capita (GNI).

This enabled the countries to be ranked by the extent of poverty theyexperienced. The first step was to rank the countries in terms of the high-est ratio of persons earning less than one US dollar per day, the countrywith the highest ratio received the highest ranking of one. The second stepwas to assign a ranking based on the gross national income per capita. Thecountry with the lowest GNI received the highest ranking of one as thepoorest country. Adding up the two rankings produced a rough povertycore. This was a crude adaptation of the Kendal’s correlation co-efficientcalculation method.


Finally the ranks were worked out from the poverty scores i.e. the low-est poverty score had the highest rank of one. There was no data from twocountries, Equatorial Guinea and Mauritius, and data on the first indicatorwas missing in three countries (Benin, the Congo DR, and the Seychelles),while Equatorial Guinea did not have data on the second indictor. The netofficial development assistance was included in the indicators as a factor inacknowledging the poverty in a country although it must be admitted thatthis is a rough measure as other than economic factors such as political sta-bility and the extent of democratisation are taken into account when con-sidering the granting of foreign aid. And, in any case, foreign aid, if equi-tably allocated, would level the poverty differentials.

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INDICATOR TABLE 5. ECONOMIC TABLE.

On the basis of the selected economic indicators, twelve of the twentycountries in the sample can be described as poor (over a quarter of the pop-ulation earn less than one US dollar per day and the gross national incomeper capita is less than 500 US dollars per annum). These are Burundi,Ethiopia, the Democratic Republic of Congo, Liberia, Malawi, Rwanda,Uganda, the Central African Republic, Tanzania, Gambia, Ghana andZimbabwe. Seven of the countries demonstrate relative economic wellbe-ing. Four of the seven, the Seychelles, Mauritius, South Africa and Egyptcan be described as medium economy countries: (reasonable GNI per capi-ta, a very low percentage of the population earning below one US dollar perday and almost totally independent of foreign aid). Three of the seven,Benin, Cote d’Ivoire, and Namibia are almost economically self-sufficient.There were no figures for Equatorial Guinea.



Certain pertinent observations can be inferred from the economic datapresented above. The five poorest countries are the Democratic Republic ofCongo, Burundi, Uganda, the Central African Republic, and Liberia. All,except Uganda and the Central African Republic have performed poorlyacross all the selected indicators of child exclusion. Both Uganda and theCentral African Republic have been free from direct armed conflict at leastover the past fifteen years. The Democratic Republic of Congo and Burundihave not fully recovered from the ravages of armed conflict, and Liberiawas directly engaged in armed conflict at the time of compilation of thisdata in 2004.

On the contrary, the most economically capable countries in the sam-ple, the Seychelles, Mauritius, South Africa and Egypt have performed wellacross all the selected indicators with the exception of HIV and AIDS in thecase of South Africa and female genital mutilation in the case of Egypt.However, all the four countries enjoy stable governments and have beenfree of armed conflict over the past thirty years or more. The political con-flict in South Africa did not disrupt continuity in government performancenor did it drain the state’s financial resources substantially, at least relativeto the economic capability of the country.

At the intermediate level where both economic capability and govern-ment stability are the key factors, the presence of armed conflict appears tobe the decisive factor. Economically Cote d’Ivoire and Benin appear to beon par. The difference is that Benin has been free from armed conflict andhas had a stable government while Cote d’Ivoire has had armed conflictwhich predictably, has made governance difficult. Cote d’Ivoire has per-formed poorly almost in all the selected indicators and Benin has per-formed relatively well.

Can these observations lead to the conclusion that while poverty is a sig-nificant factor in the exclusion of children it is the mediating factors ofarmed conflict and weak governments that exacerbate the exclusion of chil-dren? Admittedly, the poverty index used in this paper is very rough andneeds a lot of refinement. However, at a general level it seems to point atsomething worth exploring.

5.6. Health Indicators

Four selected health indicators form the substance of this section. Theyare: immunisation against preventable diseases, such as Tuberculosis,Polio, Measles, Diphtheria, and Hepatitis B, which generally afflict and at


times cripple children; access to improved drinking water, adequate sanita-tion and the number of children under fourteen years of age living withHIV and AIDS.

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TABLE 6. HEALTH INDICATORS.

5.6.1. Immunisation

Liberia, Cote d’Ivoire, Equatorial Guinea, the Democratic Republic ofCongo, the Central African Republic and to an extent Burundi performedbadly on this indicator averaging less than seventy percent of the popula-tion of children who have been immunised against the five infections. Allthe seven countries mentioned fall into the poverty bracket and two ofthem, Liberia and Cote d’Ivoire have been engaged in armed conflict in thepast five years. Predictably, relatively well off and politically stable coun-tries have performed well on the five sub indicators. Also, it appears thatthe level of international attention on any single country, especially if thereis relative peace in that country facilitates mediation in health pro-grammes. This is demonstrable in the case of Uganda, Tanzania, Ethiopia,and to an extent Burundi where, despite poverty and/or a record of previ-ous armed conflict, performance on immunisation sub indicators rangesfrom good to excellent as is the case in Uganda and Tanzania. Political sta-bility allows governments in spite of meagre resources to plan and carry outservice delivery without disruptions.



5.6.2. Adequate Sanitation

This is a function which requires both economic capability and politicalwill. The relatively rich countries: Mauritius, Egypt, the Seychelles andSouth Africa performed very well on this indicator (all above the eighty-fivepercent mark). Very poor countries such as Ethiopia, Equatorial Guinea andthe democratic Republic of Congo displayed a very poor performance recordwhere far less than half of the populations have access to improved drinkingwater. It also appears that the extent of urbanisation is a factor that affectsaccess to improved drinking water as in almost all the countries in the sam-ple, it is the rural section of the population that lacks this resource most.

5.6.3. Adequate Sanitation

Inappropriate sanitation is apparently a grave health risk in Africa.Only in Mauritius can the position be described as normal considering thehealth risks presented by improper sanitation. In South Africa and Egypt,almost two-thirds of the populations have access to adequate sanitation. Inthe rest of the countries in the sample the figure ranges from a very low ofless than one in ten in Ethiopia to a low of fifty-seven percent in Zimbabwe.There were no figures for the Seychelles.

5.6.4. Prevalence of HIV and AIDS in Children 0-14 Years

Sub-Saharan countries: South Africa, Tanzania, Zimbabwe, Ethiopiaand Malawi have the highest HIV and AIDS prevalence among children.Despite the fact that South Africa performs well almost in all the indicatorsselected in this paper, and has a sound infrastructure, a capable economyand a stable democratic government, its performance on HIV and AIDS ispoor as demonstrated both in HIV and AIDS prevalence in the reproductiveage cohort and among children under fourteen years. Also, as measured bythe deaths from AIDS related illnesses, the disease has reached maturity.

6. CONCLUSIONS

The Report by the United Nations Children Fund posits four factors;poverty, weak governments, armed conflict and HIV and AIDS as the rootcauses of exclusion of children. From the data presented in this paper, onlygeneralised and broad conclusions can be drawn.


In the first place it must be admitted that the conclusions are drawnfrom data based on national aggregates and not on individual cases,where a rigid correlation analysis could be worked out. For instance,there is no demonstrable indication of the social origins of the units thatmake up the aggregates in each country. We cannot ascertain, for exam-ple if, children from rich families in Uganda, or Ethiopia have betteraccess to immunisation programmes than do children from poorer fami-lies. Notwithstanding this admission indications are that there is merit inthe four broad postulates for exclusion.

6.1. Armed Conflict

The data treated in this paper demonstrates that whenever armedconflict is a factor, performance across all indicators declines significant-ly. Understandably, armed conflict is disruptive to government perform-ance independently of the strengths or weaknesses in government.Resources which otherwise would be directed at the delivery of goods andservices to the population are channelled into warfare, and on averagewarfare is an expensive undertaking. In addition, armed conflict drainsthe most productive human resource cohort, and amounts to a form ofbrain drain to the country. Post conflict reconstruction is another exercisethat drains state resources drastically. Armed conflict thus impacts nega-tively on the other factors of child exclusion including poverty, gover-nance and HIV and AIDS.

6.2. Poverty

The impact of poverty in the capacity to allocate and distributeresources is axiomatic. The second observation is that poverty has a spi-ralling effect on the exclusion of children. Once excluded from primaryresources such as basic nutrition and basic health services, children willbe excluded from life chance resources such as education and child pro-tection. There is evidence from the data in this paper, that poorer coun-tries perform poorly relative to their better counterparts, that whenmediated by the other factors such as weak government and HIV andAIDS, the negative impact of poverty is exacerbated. Relatively resourcedcountries perform much better on the other indicators compared to theirpoorer counterparts. For instance, despite being the epicentre of HIVand AIDS, South Africa’s performance on all the other indicators is light

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years ahead that of Uganda once the epicentre of HIV and AIDS inAfrica. And, because of the poverty index, HIV and AIDS had a devastat-ing effect on Uganda, wiping almost entire villages. Despite the gravityand magnitude, this has not been the case in South Africa, mainlybecause of the sound economic base determining a health infrastructurethat can cope with the epidemic.

6.3. Weak Government

Indications from the data are that countries with stable governmentsperformed relatively better on the selected indicators than was the casewith countries with weak governments. To aggravate the position, countrieswith unstable governments also tended to be those countries that haveexperienced protracted armed conflict.

6.4. HIV and AIDS

HIV and AIDS has a double edged sword on the exclusion of children.First it reduces children’s physical life chances, and secondly the epidemicafflicts the productive generation. As young parents, sufferers from AIDSdie from opportunistic diseases, but also as the economically active agecohort they are lost to the economic productivity of the country.

6.5. Concluding Observations

In conclusion, while a more rigorous analysis such as multiple regres-sion analysis would demonstrate the extent of correlation between the fourfactors posited by the United Nations Children’s Fund, there is ample evi-dence from the data on selected indicators presented in this paper thatpoverty, weak governments, armed conflict and HIV and AIDS constituteserious factors that exclude children from mainstream society.

SELECTED BIBLIOGRAPHY

1. Chimanikure, Donald, P, ‘Plight of Children In Conflict and PostConflict Societies: The Case of Africa’, Paper Presented at the UNU-WIDER Conference on: Making Peace Work (Helsinki 4-5 June 2004).


2. Erikson, Mikall and Wallestein, Peter, Patterns of Major Armed Conflict1990-2003, Upsala Conflict Data Project (UCDP), Department of Peaceand Conflict Research (Upsala University, 2004).

3. The United Nations Childrens Fund (UNICEF), ‘Excluded and Invisible:The State of the World’s Children’ (2006).

4. Tony Barnett and Alan Whiteside, AIDS in the 21st Century: Disease andGlobalisation (Palgrave Macmillan, New York, 2002).

PAULUS M. ZULU208


excluded and invisible children in africachildren may not be only invisible, they are unprotected as...

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